{
  "abstract": "Pretibial myxedema (PTM) is a rare extrathyroidal manifestation of Graves disease, often associated with Graves orbitopathy (GO). Tocilizumab, an interleukin-6 receptor inhibitor, is effective in refractory GO, but its role in PTM is unclear. We report the case of a 72-year-old woman with longstanding Graves disease who developed glucocorticoid-refractory GO and diffuse glucocorticoid-refractory PTM. Tocilizumab (8 mg/kg intravenously every 4 weeks) was initiated as second-line treatment of moderate to severe active GO. After 6 infusions, the patient experienced a significant improvement in both activity and severity of GO, while PTM showed near-complete resolution of edema and skin induration. No adverse events were recorded. Our findings suggest that interleukin-6 receptor inhibition with tocilizumab may represent a novel therapeutic option for refractory thyroid dermopathy, particularly in the setting of concomitant GO.",
  "abstract_shown": true,
  "affiliations": [
    "Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, CA, Italy.",
    "Ophthalmology Unit, Department of Surgical Sciences, University of Cagliari, 09042 Monserrato, CA, Italy."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Silvia Corrias"
    },
    {
      "affs": [
        0
      ],
      "name": "Aurora Arba"
    },
    {
      "affs": [
        1
      ],
      "name": "Filippo Lixi"
    },
    {
      "affs": [
        1
      ],
      "name": "Giuseppe Giannaccare"
    },
    {
      "affs": [
        0
      ],
      "name": "Francesco Boi",
      "orcid": "0000-0002-9924-5192"
    },
    {
      "affs": [
        0
      ],
      "name": "Giulia Lanzolla",
      "orcid": "0000-0001-9933-4040"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/682jqrmtkvdfe.bib",
  "cited_by": 0,
  "doi": "10.1210/jcemcr/luag249",
  "fulltext_url": "https://europepmc.org/articles/PMC13687893",
  "id": "682jqrmtkvdfe",
  "issns": [
    "2755-1520"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923586",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Ophthalmology and Eye Disorders"
    ]
  ],
  "openalex": "W7223183101",
  "pdf_url": "https://europepmc.org/articles/PMC13687893?pdf=render",
  "pmcid": "PMC13687893",
  "pmid": "42923586",
  "published": "2026-10-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/682jqrmtkvdfe.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "MED:42923586",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923586"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2712|Pituitary Gland Disorders and Treatments",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Tocilizumab in refractory pretibial myxedema: new therapeutic insights.",
  "title_text": "Tocilizumab in refractory pretibial myxedema: new therapeutic insights.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/682jqrmtkvdfe",
  "venue": "JCEM case reports",
  "versions": []
}